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Sanitha AS, Nagarajan A, Sinha SK. The patterns of anti-compensatory saccades of the SHIMP paradigm can differentiate vestibular migraine from healthy individuals. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08916-2. [PMID: 39167101 DOI: 10.1007/s00405-024-08916-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE The aim of the present study was to characterize the HIMP and SHIMP test findings in individuals with vestibular migraine. METHOD The study comprised two groups- group I consisted of twenty five adults diagnosed with Vestibular migraine, and group II comprised twenty-five age matched healthy individuals. HIMP & SHIMP were administered using the ICS impulse system for both groups. RESULTS Mann-Whitney U test revealed a significant difference (p< 0.05) in VOR gain and VOR suppression gain between the vestibular migraine and healthy individuals. All the subjects in the vestibular migraine group manifested either of the four patterns of anti-compensatory saccades (ACS): (a) bilaterally absent ACS, (b) bilaterally scattered ACS or (c) typical ACS on one side with scattered ACS on the other side (d) unilaterally absent ACS. On the other hand, all the healthy individuals exhibited the presence of an organised ACS bilaterally. CONCLUSION VOR pathway is affected in individuals with vestibular migraine. Also, various patterns of ACS are more effective in identifying the subtle vestibular lesion in vestibular migraine. These patterns are useful in differentiating vestibular migraine from healthy individuals.
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Affiliation(s)
| | - Aishwarya Nagarajan
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysore, India
| | - Sujeet Kumar Sinha
- Department of Audiology, Center of Excellence for Persons With Tinnitus and Vestibular Disorders, All India Institute of Speech and Hearing, Manasagangothri, Mysore, India
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Jasinska-Nowacka A, Niemczyk K. Application of a Video Head Impulse Test in the Diagnosis of Vestibular Neuritis. Life (Basel) 2024; 14:757. [PMID: 38929740 PMCID: PMC11204878 DOI: 10.3390/life14060757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
In patients presenting in the emergency department with acute vertigo, a rapid and accurate differential diagnosis is crucial, as posterior circulation strokes can mimic acute vestibular losses, leading to inappropriate treatment. The diagnosis of vestibular neuritis is made based on the clinical manifestation and a bedside otoneurological assessment. In the clinical examination, an evaluation of the vestibulo-ocular reflex is the key element; however, the accuracy of the bedside head impulse test depends on the clinician's experience. Thus, new diagnostic methods are needed to objectify and facilitate such rapid vestibular evaluations. The aim of our paper is to provide a comprehensive review of the video head impulse test's application in the diagnosis of vestibular neuritis. Numerous studies have reported advantages that make this method helpful in detailed otoneurological evaluations; in contrast to the bedside head impulse test, it enables an analysis of all six semicircular canals function and records the covert corrective saccades, which are invisible to the naked eye. As a portable and easy diagnostic tool, it is known to improve the diagnostic accuracy in patients with acute vertigo presenting in the emergency department. Moreover, as it evaluates the vestibulo-ocular reflex across different frequencies, as compared to caloric tests, it can be used as an additional test that is complementary to videonystagmography. Recently, several papers have described the application of the video head impulse test in follow-up and recovery evaluations in patients with vestibular neuritis.
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Affiliation(s)
- Agnieszka Jasinska-Nowacka
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-091 Warszawa, Poland;
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Marcelli V, Giannoni B. A Clinical Infrared Video-Oculoscopy Suppression Head Impulse (IR-cSHIMP) Test. Audiol Res 2024; 14:151-165. [PMID: 38391770 PMCID: PMC10886088 DOI: 10.3390/audiolres14010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND We propose a Suppression Head IMPulse (SHIMP) test method that provides for equipment only through the use of InfraRed Video-OculoScopy (IR-VOS) and allows horizontal and vertical semicircular canal function evaluation in bedside mode. We therefore named the test InfraRed clinical SHIMP (IR-cSHIMP). METHODS To check IR-cSHIMP diagnostic efficiency, we studied 22 normal subjects, 18 patients with unilateral, and 6 with bilateral deficient vestibulopathy. Each subject first underwent a vestibular examination and, only later, an IRc-SHIMP test. RESULTS When the IR-cSHIMP test was performed in the horizontal plane, all normal subjects showed anti-compensatory saccades. When the vertical semicircular canal function was evaluated, the same result was obtained in all normal subjects except three, which were considered false positives. In patients with vestibular deficits, the test performed in the horizontal and vertical planes were always pathological, with 100% agreement between clinical and instrumental tests. CONCLUSIONS Our bedside method proved to be fast, simple, and effective in discriminating between healthy and pathological subjects. It required only the same skill as the better-known cHIT. For these reasons, we believe that the IR-cSHIMP should be part of daily clinical practice as a useful tool in the selection of patients to undergo more sophisticated investigations.
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Affiliation(s)
| | - Beatrice Giannoni
- Unit of Audiology, Department of Neuroscience, Psychology, Drug's Area, and Child's Health, University of Florence, 50134 Florence, Italy
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The Clinical Use of the Suppression Head Impulse Paradigm in Patients with Vestibulopathy: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071182. [PMID: 35885709 PMCID: PMC9320756 DOI: 10.3390/healthcare10071182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This review aims to explore the potential clinical application of the suppression head impulse paradigm (SHIMP) in patients with unilateral and bilateral vestibulopathy. Methods: An electronic search was conducted by two independent reviewers in the following databases: Embase, MEDLINE (PubMed), and Scopus. The screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers. The included studies were quality appraised using a modified version of the Newcastle–Ottawa Scale. Results: The results were reported following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Our search yielded 935 unique records, of which 16 remained after screening titles and abstracts. A total of 11 studies were included, covering a total of 418 participants (230 patients and 188 healthy participants). Conclusion: SHIMP could be a useful tool to diagnose a VOR alteration in patients with vestibulopathy in both the acute and chronic phases of vestibulopathy.
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van Dooren T, Starkov D, Lucieer F, Dobbels B, Janssen M, Guinand N, Pérez Fornos A, Kingma H, Van Rompaey V, van de Berg R. Suppression Head Impulse Test (SHIMP) versus Head Impulse Test (HIMP) When Diagnosing Bilateral Vestibulopathy. J Clin Med 2022; 11:jcm11092444. [PMID: 35566570 PMCID: PMC9102589 DOI: 10.3390/jcm11092444] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
The Suppression Head Impulse (SHIMP) test was introduced as an alternative to the Head Impulse Paradigm (HIMP) to overcome challenges in VOR gain calculation due to the interference of covert saccades. The objectives of this study were (1) to determine if SHIMP, compared to HIMP, reduces covert saccades in BV patients and (2) to define the agreement on diagnosing BV between SHIMP and HIMP. First, the number of covert saccades was compared between SHIMP and HIMP. Secondly, VOR gain was compared between SHIMP and HIMP. Lastly, the agreement between SHIMP and HIMP on identifying BV (horizontal VOR gain <0.6) was evaluated. A total of 98 BV patients were included. To our knowledge, this is the largest study population on SHIMP testing in BV patients. Covert saccades were significantly reduced, and a lower VOR gain was found during SHIMP compared to HIMP (p < 0.001). However, the clinical relevance of these statistically significant differences is small. In 93% of the patients, an agreement was found between the two paradigms regarding the diagnosis of BV, and both paradigms detect BV in the vast majority of patients.
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Affiliation(s)
- Tessa van Dooren
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (F.L.); (N.G.); (H.K.); (R.v.d.B.)
- Correspondence:
| | - Dmitrii Starkov
- Faculty of Physics, Tomsk State Research University, 634050 Tomsk, Russia;
| | - Florence Lucieer
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (F.L.); (N.G.); (H.K.); (R.v.d.B.)
| | - Bieke Dobbels
- Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium; (B.D.); (V.V.R.)
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Miranda Janssen
- Department of ENT/Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands;
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Nils Guinand
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (F.L.); (N.G.); (H.K.); (R.v.d.B.)
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Angelica Pérez Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Herman Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (F.L.); (N.G.); (H.K.); (R.v.d.B.)
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium; (B.D.); (V.V.R.)
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands; (F.L.); (N.G.); (H.K.); (R.v.d.B.)
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The feasibility of SHIMP for judging subjective vertigo and recovery in patients with vestibular neuritis. Eur Arch Otorhinolaryngol 2022; 279:3211-3217. [PMID: 35296947 DOI: 10.1007/s00405-022-07299-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/03/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE We aimed to study the results of the head impulse paradigm (HIMP) and the suppression head impulse paradigm (SHIMP) in patients with acute vestibular neuritis (AVN) to compare dizziness handicap inventory (DHI) scores before and after treatment. We also wanted to investigate the correlation between the HIMP, SHIMP and DHI score and to analyze the factors that affect the recovery with AVN in the short term. METHODS The HIMP, SHIMP, and DHI score were assessed in 20 patients with AVN before (T0) and after treatment (T1). We collected the following indicators: T0, T1-HIMP VOR gain; T0, T1-SHIMP VOR gain; the percentage of the anti-compensatory saccades of T0-SHIMP and T1-SHIMP on the affected side; T0-DHI score, T1-DHI score; and efficacy index (EI). The correlation between HIMP and SHIMP parameters with the DHI score and EI was analyzed, and the factors that affect the recovery of patients with AVN were assessed. RESULTS T0-SHIMP anti-compensatory saccades (%),T1-SHIMP VOR gain, and T1-SHIMP anti-compensatory saccades (%) were significantly correlated with the corresponding DHI score and EI (P < 0.05). T0, T1-HIMP VOR gain and T0-SHIMP VOR gain had no correlation with the corresponding DHI score and EI (P > 0.05). T0-SHIMP anti-compensatory saccades (%) significantly affect EI (P < 0.05). CONCLUSION Both HIMP and SHIMP can assess the current vestibular function and recovery of AVN patients, but SHIMP can more accurately reflect the degree of subjective vertigo. At the same time, T0-SHIMP anti-compensatory saccades (%) can be used as a good index to evaluate the short-term recovery of AVN patients.
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Chen F, Chen Z, Zhang Y, Wei X, Zhao H, Hu J, Cheng Y, Ren X, Zhang Q. Association Analysis of HIMP and SHIMP Quantitative Parameters in Patients With Vestibular Neuritis and Healthy Participants. Front Neurol 2021; 12:748990. [PMID: 34777221 PMCID: PMC8579954 DOI: 10.3389/fneur.2021.748990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP) are objective, quantitative methods that directly test the vestibulo-ocular reflex (VOR) and are increasingly becoming a standard in evaluating patients with vestibular disorders. Objective: The main objective was to assess the correlations between HIMP and SHIMP parameters in patients with superior vestibular neuritis (VN) and healthy participants. Additionally, the correlations between the parameters of each method were analyzed. Methods: A retrospective cohort, non-randomized study was designed. HIMP and SHIMP were performed on 40 patients with VN and 20 healthy participants (40 ears). HIMP and SHIMP parameters were measured and calculated. Pearson's or Spearson's correlations were used to establish the associations among them. Results: A strong positive correlation was found between HIMP and SHIMP gain (Pearson's r = 0.957, p = 0.000), while strong negative correlations were detected between HIMP and SHIMP saccade amplitudes (r = -0.637, p = 0.000) and percentages of overt saccades (r = -0.631, p = 0.000). In HIMP, strong and moderate positive correlations were identified between gain and saccade amplitude (R 2 = 0.726, p = 0.000) and gain and saccade percentage (R 2 = 0.558, p = 0.000), respectively. By contrast, an extremely weak positive correlation was observed between gain and latency (R 2 = 0.053, p = 0.040). In SHIMP, strong and moderate positive correlations were found between gain and saccade percentage (R 2 = 0.723, p = 0.000) and gain and saccade amplitude (R 2 = 0.525, p = 0.000), respectively, but no correlation was detected between gain and latency (R 2 = 0.006, p = 0.490). Conclusions: HIMP and SHIMP-related parameters were highly correlated (inter-method). Within each method (intra-method), moderate to strong correlations in VOR assessment were observed. These results further contribute to our understanding of the relationship between HIMP and SHIMP as well as to the diagnosis.
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Affiliation(s)
- Feiyun Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zichen Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuzhong Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinyu Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huandi Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Hu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qing Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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Starkov D, Vermorken B, Van Dooren TS, Van Stiphout L, Janssen M, Pleshkov M, Guinand N, Pérez Fornos A, Van Rompaey V, Kingma H, Van de Berg R. The Effect of Different Head Movement Paradigms on Vestibulo-Ocular Reflex Gain and Saccadic Eye Responses in the Suppression Head Impulse Test in Healthy Adult Volunteers. Front Neurol 2021; 12:729081. [PMID: 34630303 PMCID: PMC8492894 DOI: 10.3389/fneur.2021.729081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/18/2021] [Indexed: 02/03/2023] Open
Abstract
Objective: This study aimed to identify differences in vestibulo-ocular reflex gain (VOR gain) and saccadic response in the suppression head impulse paradigm (SHIMP) between predictable and less predictable head movements, in a group of healthy subjects. It was hypothesized that higher prediction could lead to a lower VOR gain, a shorter saccadic latency, and higher grouping of saccades. Methods: Sixty-two healthy subjects were tested using the video head impulse test and SHIMPs in four conditions: active and passive head movements for both inward and outward directions. VOR gain, latency of the first saccade, and the level of saccade grouping (PR-score) were compared among conditions. Inward and active head movements were considered to be more predictable than outward and passive head movements. Results: After validation, results of 57 tested subjects were analyzed. Mean VOR gain was significantly lower for inward passive compared with outward passive head impulses (p < 0.001), and it was higher for active compared with passive head impulses (both inward and outward) (p ≤ 0.024). Mean latency of the first saccade was significantly shorter for inward active compared with inward passive (p ≤ 0.001) and for inward passive compared with outward passive head impulses (p = 0.012). Mean PR-score was only significantly higher in active outward than in active inward head impulses (p = 0.004). Conclusion: For SHIMP, a higher predictability in head movements lowered gain only in passive impulses and shortened latencies of compensatory saccades overall. For active impulses, gain calculation was affected by short-latency compensatory saccades, hindering reliable comparison with gains of passive impulses. Predictability did not substantially influence grouping of compensatory saccades.
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Affiliation(s)
- Dmitrii Starkov
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - Bernd Vermorken
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - T S Van Dooren
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Lisa Van Stiphout
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Miranda Janssen
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Maksim Pleshkov
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - Nils Guinand
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Angelica Pérez Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Herman Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - Raymond Van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Center, Maastricht, Netherlands.,Faculty of Physics, Tomsk State Research University, Tomsk, Russia
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Kumar RT, Sinha SK. Head Impulse Test Paradigm and Suppression Head Impulse Test Paradigm in Individuals With and Without Motion Sickness. Am J Audiol 2021; 30:518-523. [PMID: 34121426 DOI: 10.1044/2021_aja-21-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study aimed to assess the vestibuloocular reflex (VOR) gain using both the Head Impulse Test Paradigm (HIMP) and Suppressive Head Impulse Test Paradigm (SHIMP) in individuals with motion sickness. Method Fifty eight participants (58 females) in the age range of 18-25 years were recruited for the study. The participants were divided into two groups, Group A had 29 participants with no motion sickness, and Group B consisted of 29 individuals who had motion sickness. All the participants underwent HIMP and SHIMP testing. Results None of the participants had a presence of saccades in the HIMP technique, and all the participants in both the groups had anticompensatory saccades in SHIMP technique. Also, there was no difference in VOR gain or VOR gain asymmetry between individuals with and without motion sickness using HIMP and SHIMP Techniques. Conclusions The results of the study show no differences in VOR gain between individuals with and without motion sickness. It has been reported that only low frequencies trigger the motion sickness. Since the Video Head Impulse Test assesses the high frequency, it may not be an ideal technique to evaluate the vestibular system in individuals with motion sickness.
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Affiliation(s)
- Rakesh T. Kumar
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru
| | - Sujeet Kumar Sinha
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru
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10
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Milkov M. Recent advances in the diagnosis of some common vestibular disorders. SCRIPTA SCIENTIFICA MEDICA 2021; 53:21. [DOI: 10.14748/ssm.v0i0.7999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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11
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Manzari L, Princi AA, De Angelis S, Tramontano M. Clinical value of the video head impulse test in patients with vestibular neuritis: a systematic review. Eur Arch Otorhinolaryngol 2021; 278:4155-4167. [PMID: 33893851 DOI: 10.1007/s00405-021-06803-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/07/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this systematic review was to evaluate the clinical application potential of the video head impulse test (vHIT) in diagnosing vestibular neuritis (VN). METHODS An electronic search was conducted in the following databases: Embase, MEDLINE, ScienceDirect, Google scholar, and the Cochrane Database of Systematic Reviews. Clinical studies were included in which an evaluation was made using vHIT either alone or in combination with other tests or bedside algorithms. Evaluations that were carried out using unvalidated tools were excluded. Only studies of patients with VN (superior, inferior, or in toto) were included. Screening of titles, abstracts, full texts, and data extraction were undertaken independently by pairs of reviewers. Included studies were quality appraised using a modified version of the Newcastle-Ottawa scale. RESULTS Results were reported according to the preferred reporting items for systematic reviews and meta-analyses. Our search yielded 1309 unique records, 21 of which remained after screening titles and abstracts. Sixteen studies were included, i.e., for a total of 933 patients including 474 patients with a diagnosis of VN. CONCLUSIONS The diagnostic value of vHIT is high for VN, as it is a high-frequency measurement tool. vHIT is a useful complement or alternative to caloric and rotational tests as an indicator of lesions of vestibular canal functioning, especially at the time of onset. This tool can provide useful clues about the clinical progress of recovery from the lesion through the value of the vestibulo ocular reflex gain and the consequent evolution of the saccade pattern, which allows the patient to stabilize vision on the retina.
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Affiliation(s)
| | | | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
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12
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Hawkins KE, Rey-Martinez J, Chiarovano E, Paul SS, Valldeperes A, MacDougall HG, Curthoys IS. Suppression head impulse test paradigm (SHIMP) characteristics in people with Parkinson's disease compared to healthy controls. Exp Brain Res 2021; 239:1853-1862. [PMID: 33846841 DOI: 10.1007/s00221-021-06107-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/02/2021] [Indexed: 11/24/2022]
Abstract
The suppression head impulse test paradigm (SHIMP) is a newly described indicator of vestibular function which yields two measures: vestibulo-ocular reflex (VOR) gain and a saccadic response. It is an alternative and complementary test to the head impulse test paradigm (HIMP). Parkinson's disease (PD) has known saccadic and central vestibular pathway dysfunction. This paper is the first description of SHIMP VOR gain and saccade characteristic in this population. This prospective observational study measured the SHIMP VOR gain and saccade characteristics in 39 participants with idiopathic PD and compared this to 40 healthy controls (HC). The effect of group, demographic variables and SHIMP characteristics were evaluated. SHIMP VOR gains were not significantly different between groups (p = 0.10). Compared to HC, the PD group mean SHIMP peak saccade velocity was significantly reduced by an average of 77.07°/sec (p < 0.001), and SHIMP saccade response latency was longer, with an average delay of 23.5 ms (p = 0.003). SHIMP saccade peak velocity was also associated with both head impulse velocity (p = 0.002) and SHIMP VOR gain (p = 0.004) variables, but there was no significant influence of these variables when SHIMP saccade peak velocity was considered as a predictor of PD (p = 0.52-0.91). VOR gains were unaffected by PD. PD-specific saccadic dysfunction, namely reduced peak saccade velocities and prolonged response latencies, were observed in the SHIMP-induced saccade responses. VOR gain using slow phase eye velocity is preferred as the indicator of vestibular function in the SHIMPs paradigm as non-vestibular factors affected saccade peak velocity.
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Affiliation(s)
- Kim E Hawkins
- Vestibular Research Laboratory, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia.
| | - Jorge Rey-Martinez
- Neurotology Unit, ENT department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - Elodie Chiarovano
- Sydney Human Factors Research, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Serene S Paul
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ariadna Valldeperes
- Neurotology Unit, ENT department, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
| | - Hamish G MacDougall
- Sydney Human Factors Research, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
| | - Ian S Curthoys
- Vestibular Research Laboratory, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia
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Casani AP, Canelli R, Lazzerini F, Navari E. Prognosis after acute unilateral vestibulopathy: Usefulness of the suppression head impulse paradigm (SHIMP). J Vestib Res 2021; 31:531-540. [PMID: 33814480 DOI: 10.3233/ves-210038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This cross-sectional study aims to describe the features of the suppression head impulse paradigm (SHIMP) in acute unilateral vestibulopathy (AUV) and to define its role in predicting the recovery of patients. METHODS Thirty patients diagnosed with AUV were retrospectively analyzed. The dizziness handicap inventory score and video head impulse test parameters performed 4-8 weeks from the AUV onset constituted the main outcome measures. Patients with a worse recovery (Group 1) and patients who recovered spontaneously (Group 2) were compared. RESULTS The SHIMP vestibulo-ocular reflex (VOR) gain was statistically significantly lower than the conventional head impulse paradigm (HIMP) VOR gain (P < 0.001). The SHIMP VOR gain was negatively correlated with the DHI (P < 0.001) and was positively correlated with the HIMP VOR gain (P < 0.001) and the SHIMP overt saccades (%) (P < 0.001). Patients with a worse recovery exhibited the following: higher DHI (P < 0.001), lower SHIMP and HIMP VOR gain (P < 0.001 and P = 0.007, respectively), and lower SHIMP and greater HIMP overt saccade prevalence values (P = 0.007 and P = 0.032, respectively). CONCLUSIONS The SHIMP and HIMP help in improving our approach to AUV. SHIMP appears to better identify the extent of the vestibular damage in patient suffering from AUV than HIMP and could provide interesting information about the course of the disease. Particularly, the analysis of SHIMP VOR gain and overt saccade prevalence would provide useful information about the recovery of patients.
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Affiliation(s)
- Augusto Pietro Casani
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Pisa, Italy
| | - Rachele Canelli
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Pisa, Italy
| | - Francesco Lazzerini
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Pisa, Italy
| | - Elena Navari
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Pisa, Italy
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Starkov D, Strupp M, Pleshkov M, Kingma H, van de Berg R. Diagnosing vestibular hypofunction: an update. J Neurol 2021; 268:377-385. [PMID: 32767115 PMCID: PMC7815536 DOI: 10.1007/s00415-020-10139-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 12/13/2022]
Abstract
Unilateral or bilateral vestibular hypofunction presents most commonly with symptoms of dizziness or postural imbalance and affects a large population. However, it is often missed because no quantitative testing of vestibular function is performed, or misdiagnosed due to a lack of standardization of vestibular testing. Therefore, this article reviews the current status of the most frequently used vestibular tests for canal and otolith function. This information can also be used to reach a consensus about the systematic diagnosis of vestibular hypofunction.
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Affiliation(s)
- Dmitrii Starkov
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
- Faculty of Physics, Tomsk State Research University, Tomsk, Russia.
- Maastricht University ENT Department, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - Michael Strupp
- German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany
- Department of Neurology, Ludwig Maximilians University, Munich, Germany
| | - Maksim Pleshkov
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - Herman Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State Research University, Tomsk, Russia
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State Research University, Tomsk, Russia
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15
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Kirazli G, Hepkarsi S, Kirazli T. Evaluation of high frequency horizontal VOR parameters in patients with chronic bilateral and unilateral peripheral vestibulopathy: a preliminary study. Acta Otolaryngol 2020; 140:1007-1012. [PMID: 32862738 DOI: 10.1080/00016489.2020.1810314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Caloric test is one of the tests which evaluates the low frequency component of vestibular system for both diagnosis of the BPV and UPV. AIMS The main objectives are to determine and increase the diagnostic value of BPV and UPV by evaluating the high frequency horizontal VOR parameters with HIMP, SHIMP and fHIT, to compare test results with healthy controls, and to evaluate correlation of these tests with vertigo dizziness imbalance (VDI) questionnaire results in these patients. MATERIAL AND METHODS Six patients with BPV, ten patients with UPV and fifteen healthy controls were recruited. High frequency hVOR were evaluated with HIMP, SHIMP and fHIT. Vestibular symptoms and quality of life were assessed with VDI Questionnaire. RESULTS Lower percentage of correct answers, and lower VOR gains were obtained in affected sides for BPV and UPV. HIMP elicited compensatory saccades in patients, whereas SHIMP elicited large anticompensatory saccades in controls and unaffected side of UPV, but no saccades in BPV. No correlation was found between VDI outcomes and all tests. CONCLUSIONS The results show that all tests are complementary each other and able to identify the affected labyrinth and to show residual vestibular function. These tests are thought to be important in the vestibular rehabilitation process.
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Affiliation(s)
- Gulce Kirazli
- Audiometry Program, Ataturk Health Services Vocational High School, Ege University, Izmir, Turkey
| | - Sevinc Hepkarsi
- Otorhinolaryngology Department, School of Medicine, Ege University, Izmir, Turkey
| | - Tayfun Kirazli
- Otorhinolaryngology Department, School of Medicine, Ege University, Izmir, Turkey
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Suppression Head Impulse Paradigm (SHIMP) in evaluating the vestibulo-saccadic interaction in patients with vestibular neuritis. Eur Arch Otorhinolaryngol 2020; 277:3205-3212. [PMID: 32472160 DOI: 10.1007/s00405-020-06085-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Evaluate the potential clinical application of the Suppression Head Impulse Paradigm (SHIMP) in evaluating the vestibulo-saccadic interaction in patients with vestibular neuritis (VN). METHODS A retrospective study was performed. Fifteen patients diagnosed with unilateral VN were identified from a database of ENT vestibular clinic from January 2011 to February 2020. Medical records were reviewed to determine clinical presentation, vestibular testing results, treatment, and recovery. RESULTS Fifteen patients (7 left ear, 8 right ear, mean age 58.73 ± 10.73, six female) met the inclusion criteria and were enrolled in the study. Significant differences were found in the within-subjects analysis at T1 in DHI score (p = 0.001), VOR gain (p < 0.005), and in the percentages of impulses containing a SHIMPs saccade when the head is passively turned toward the affected side (p = 0.001). CONCLUSIONS SHIMPs paradigm provides useful information about the value of vestibulo-saccadic interaction as new recovery strategies in patients with VN.
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